Control of Blood Pressure in Elderly Patients with Heart Failure and Risk of Mortality
Bibliographic record
Abstract
Background: Blood pressure (BP) targets in elderly patients with heart failure (HF) are unclear and guidelines are based on expert consensus and extrapolation from populations without HF. Thus, our population-based prospective cohort study assessed if BP control <140/90 mmHg is associated with a decreased risk of mortality in elderly HF patients. Methods: We included participants of the Berlin Initiative Study, all ≥70 yrs, with HF and treated with antihypertensive drugs at baseline (2009-2011). Demographics, lifestyle factors, medication, and comorbidities were obtained in face-to-face interviews and linked with administrative healthcare data. BP status was defined as normalized BP (systolic BP <140 and diastolic BP <90 mmHg) or non-normalized BP (systolic BP ≥140 or diastolic BP ≥90 mmHg) and updated every 2 yrs, so that each patient could contribute person-time to both exposure categories during follow-up. Time-dependent Cox proportional hazards models estimated adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of cardiovascular death and all-cause mortality associated with normalized BP compared with non-normalized BP in HF patients. Analyses were repeated in non-HF patients. Results: There were 544 HF patients treated with antihypertensive drugs (mean age 82.8 yrs; 45.4% female). During a median f/up of 7.5 yrs and compared with nonnormalized BP, normalized BP was associated with an increased risk of cardiovascular death (HR, 1.79; 95% CI, 1.23-2.61) and all-cause mortality (HR, 1.48; 95% CI, 1.15-1.90). No increased risks of cardiovascular death (HR, 1.23; 95% CI, 0.87-1.74) or allcause mortality (HR, 1.19; CI 0.95-1.49) associated with normalized BP were observed among 1079 non-HF patients. Conclusions: BP <140/90 mmHg was not associated with a decreased risk of mortality in elderly HF patients. The increased risk requires further confirmation. Funding: Private Foundation SupportRisk of cardiovascular death and all-cause mortality associated with normalized BP in older adults with HF
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".